Wednesday, July 14, 2010

House Veterans Affairs suicide hearing

The US House Veterans Affairs Committee has numerous subcommittees. Today we attended a hearing of the Subcommittee on Oversight and Investigations, chaired by Harry Mitchell, exploring suicides and the efforts at outreach by the VA.

The first panel was my favorite. There were two witnesses. One was a veteran, Melvin Cintron, and he did a wonderful job. The other was Linda Bean and she broke my heart.

She is the mother of Coleman Bean. And she went through what happened to her son (he deployed to Iraq twice and committed suicide when back in the US). I just wanted to thank her for sharing because it's never easy to share something personal to a crowd of people and to do so about something so personal and so devastating.

Her son did two tours in Iraq. He was 25-years-old when he took his own life. She said in her opening statement, "It is my hope that these observations, which are drawn from a shared experience of loss, will be useful to you as you oversee the continued development and implementation of suicide prevention programs."

And that's great but that makes it no easier for her to just open up the way she did. And I wondered about the questions because some weren't all that easy. But she was matter of fact in her replies and straightforward and, if she wasn't sure if she'd respondend to the question, she'd ask if her answer was satisfactory.

Coleman Bean must have really been a special guy because, yes, every mother loves their child but Linda Bean really put herself through the ringer (wringer?) and you could really sense how special her son was to her when she spoke.

I was a little cry baby and felt like a fool at one point and then I looked over and saw C.I. (taking notes) with a tear streaming down the side of her face facing me. So I wasn't the only one impressed with Ms. Bean.

I have a copy of her opening statements and I am going to include her recommendations from that:

I believe it is crucial that the VA:Identify and publicize civilian counseling alternatives, including The Soldier's Project, GiveAnHour and The National Veterans Foundation.Partner with civilian organizations to assure that all vets have immediate access to a wide range of mental-health care, andEncourage media outlets to publish local information on mental-health resources for veterans.Second, I believe it is critical to implement a simple, straightforward public information campaign geared specifically to veterans' family members and friends. It may fall to a grandmother, a best friend or a favorite neighbor to seek out help for a veteran who is suffering. Make information on available services easy to find and understand and publish it broadly. The suicide hotline number is not enough.Help veterans help each other. The VA is confronting PTSD and suicide with new programs and new research, good and important work. But that hasn't always been the case and there are vets who will tell you that they have had to scrap and fight for every VA service they've received. In addition to the official patient-advocacy complaint resolution program, please establish a peer body -- made up of the most feisty, tenacious veterans. They will help assure that no vet gives up because it just got too hard or took too long to navigate the VA system.

Wednesday, July 14, 2010. Chaos and violence continue, the US House explores the issue of veterans' suicides, the US Senate addresses claims issues, Bradley Manning needs support, and more.

Linda Bean: I think what -- There are families like mine who have experienced the home coming of a much loved child who is now out of harm's way and you are so grateful that they are back with you that you may overlook the fact that they are drinking too much or that they are irritated or that they insist upon being isolated. And you're not empowered as a mother or a sister or a wife to go to the VA and say, "My veteran is in trouble." I don't even know that I would have known how to do that. I think in the way that Mr. Cintron described we need to make sure that people know there are places to go before you hit the suicide hotline. There are veterans who are not -- who may, in the end, be alone in a room with a gun to their heads but the day before would not describe themselves to you as suicidal. So I -- I guess I would go back to my very strong feeling that as part of that, in addition to the messaging, we need to make sure that there are community based programs that are easily accessible. And we need to make sure that the information the VA has is geared to family and friends in a friendly and accessible way, made easily available so people can find it. And that the VA is willing to say, "Look, if you won't come here, it's okay. We'll help you find help somewhere else."

Linda Bean is the mother of Coleman Bean and the above is from her replies to questions from Committee Members today. Coleman Bean served two deployments in the Iraq War and was an army Sergeant. He returned home and struggled, taking his own life September 6, 2008. His mother was testifying this morning to the House Veterans Affairs Subcommittee on Oversight and Investigations which is chaired by US House Rep Harry Mitchell. We'll note this from Mitchell's opening remarks.

Chair Harry Mitchell: As Chairman of this Subcommittee, I have repeatedly called upon the VA to increase outreach to veterans who need mental health services and are at risk of suicide -- and members on both side of the aisle have urged the same. In 2008, the VA finally reversed its long-standing self-imposed ban on television and their families about where they can turn for help. As part of the campaign, the VA produced a public service announcement featuring Gary Sinise, and distributed it to 222 stations around the country that aired it more than 17,000 times. The VA also placed print ads on buses and subway trains. According to the VA's own statistics, the effort proved successful. As of April 2010, the VA has reported nearly 7,000 rescues of actively suicidal veterans, which were attributed to seeing the ads, PSAs, or promotional products. Additionally, referrals to VA mental health services increased.

We're going to jump to US House Rep John Hall's questions because PSAs -- and when they air -- come up during that.

US House Rep John Hall: It's been obvious to many of us that when a person joins the military, they should also be automatically enrolled in the VA. And that members of the armed forces and their families should have access to their information and education about assimilating back into civilian life, into their communities before, during and after deployment. One of the problems as I see it here is that the Veterans Affairs Committee has one piece of jurisdiction and the Armed Services Committee has another one, on the executive side, there is one piece and the VA has another piece and there's not that overlap and seamless transition that we've talked about in so many ways -- not just medical records but health follow up. So perhaps, Ms. Bean, you could talk a little bit about what kind of information or resources were available to you and to your son before he took his life? What kind of outreach was there? You've told us a little bit about what you'd like to see available but was there any of substance?

Linda Bean: We have -- we have a strong VA system in New Jersey. When Coleman came home from his second tour of duty, the VA services were certainly available to him. Mental health care is at a premium and it's difficult to get an appointment in a timely fashion. I don't know when or how Coleman called the VA to seek mental health assistance. That's something that we learned only after Coleman had died. I didn't know -- this is a gap in my own understanding as much as anything else -- I didn't know what else was available. I didn't go looking for something else to be available and it wasn't until Coleman had died that I learned that there were many other programs that could have been available. I keep going back to the idea that, you know, our local newspaper run Little League box scores, we run the Butterball turkey hotline at Thanksgiving, we put out notices about bowling leagues. I think our local newspapers and radio stations could run a little box of resources. If you're a vet, if you're a soldier, if you're a family, you can go to these places for help. And that list could include the VA hospital and the vet centers. But it needs to go beyond that to include civilian resources, localized civilian resources. I'm not sure I'm answering the question.

US House Rep John Hall: No, that's helpful. Thank you. Mr. Cintron, would you discuss the kind of prevention that might help a veteran from reaching the point where they take their own life? We've heard about how Coleman and other veterans have -- have no exhibited or used the word suicide and then not exhibit those tendencies until it was too late. So what kind of outreach would you suggest could reach a veteran before they get to that point?

Warrant Officer Melvin Cintron: I think there are a few outreach efforts that can be done. But the first step would have to be to have the people to reach out to and that can reach out to the folks. And they have to have some minimal training. Not a lot. All it takes, often times, like I said, I've encountered many veterans and they start talking to me and share their experience. And it's like, "Wow, you don't the weight that was on me." And it just lingers with them. And al they wanted to do was get it out at least once with someone that can understand -- not to judge, but just listen to them. That? That's what needed. Those outreaches, I think, you know when you get with some of the groups that are available to us, if there's a combined effort with the groups, find the synergy with them and with the government organization so that we all own part of the solution and it's not just a VA solution, not just a DoD solution, not just the solution of any individual program. It is a combined solution we all own part of it. So the outreach would be retraining and identifying personnel who are willing to take the call -- at any [time]. Anybody -- I give my phone to friends and veterans that I need and I say, "Hey, if you ever have an issue, call." And I have actually received calls in the middle of the night. I was just thinking about this. And we talked through and we're done. But having that outreach -- the ability to call somebody -- doesn't have to be somebody that they know but it has to be somebody that knows what it is that they're going through.

US House Rep John Hall: Thank you. I know I'm over my time. But I would just mention that this committee has -- the full Veterans Affairs Committee on the House side has voted to give funding not just for PSA, as Ranking Member Roe mentioned, but for paid advertising. And IAVA who will hear from shortly partnered with the Ad Council in one effort to put together an ad that was more powerful than the average PSA -- Public Service Announcement -- shown in the middle of the night because that's when the time's the cheapest and the TV station will give it up to do there public service whereas what we really need is advertising during the Superbowl, during American Idol, during the highest rated shows, during prime time where the half-hours -- I mean, the thirty-second spot costs the most money. But we're willing to do that to advertise "Be All That You Can Be" [Army recruitment ad], or "The Few, The Proud, The Marines" -- you know, the lightening bolt coming down onto the sword. And if we want to recruit and attract people to go into the armed services and to go fight for our country, we'll spend the money for prime time advertising but when it comes time to help them find the resources that they need to stay healthy after they come home, we want to do it on the cheap. And just do it at 3:00 a.m. in the morning on a PSA. And I think that needs to change, something we in Congress should fund so that the outreach is just as strong afterwards as it is before they were recruited.

Linda Bean and Warrant Officer Melvin Cintron were the witnesses on the first panel. Melvin Cintron served in both the first Gulf War and in the current Iraq War. From Cintron's opening remarks, there's something that has to be noted because VA and military officials repeatedly deny that it happens but it does happen and it's not by accident.

Warrant Officer Melvin Cintron: As an example, when returning from Iraq, as we out processed in Fort Dix, New Jersey, in an auditorium, a sergeant asked, "Is there anybody here who feels they need to talk to someone about anything they saw or did?" Nobody raised their hand. He then stated, "If you want to do it confidentially, please sign the roster that will be in the adjoining room." On the day prior to our leaving the out processing center the sergeant again addressed the crowd of soldier and, with the pad in his hand, he read out the names of those soldiers that had signed up confidentially for the offer made the previous day and asked, "Do you still need to see somebody?" Needles to say, nobody responded with a "yes." I was one of those soldiers.

It happens, it's not an accident. And it would end tomorrow if the brass took it (and the need for mental health) seriously. This is not the first time Cintron has publicly shared that story. He's never had anyone call him up and say, "This sergeant that you're talking about. Not to get him in trouble, but just to talk to him and correct this behavior, could you tell me what his name is?" There's never been a follow-up and there probably never will be. Until there is, the commanders can pretend that they're 'changing' the attitudes but they're not doing a damn thing.

PSAs? When someone's despondent, it's most likely going to be during the middle of the night. That is usually why, in fact, you're not asleep like many people. (You can also be up because you work nights or because you're an insomniac or you had too much caffeine.) So it's good that they're available then. They should, as Rep Hall noted, be available at other times as well. But, to be clear, he wasn't just talking about the standard PSAs. He was talking about the ones that could reach those struggling before suicidal thoughts became the norm. Before he questioned Linda Beam, she'd already been asked what type of PSA she thought was needed.

Linda Bean: I think it would be the Public Service Announcement that said, "You're home, you're drinking too much, you're fighting with your wife, you can't get along with your boss, you need help." That's a message that resonates with people who are in that position. The message that says, "You're home and you're suicidal"? Not so much.

And this was why he was referring to Iraq and Afghanistan Veterans of America's ad they made with the Ad Council which went far beyond the standard PSA of "Here's a number to call." I'm not mentioning Republicans, I'm not mentioning them for a reason. I didn't enjoy the crap that went down at one point. Others at the hearing may report on it at their sites. If so, we'll link to them in tomorrow's snapshot and note the issues. Today, I'll just give all the Republicans a demerit and ignore them and hope they can bring one of their own in to order. (Hint, it's not about you. What a witness went through, their pain, is not about you. Nor is it a competition. You're a member of Congress and should show a little dignity.) I was at the hearing of the House Subcommittee for the start through the first two panels. I then went to Senate Veterans Affairs Committee hearing on veterans' claims processing. I had missed the first portion where Chair Daniel Akaka and other Committee Members had heard from and questioned VA's Acting Under Secretary For Benefits Michael Walcoff. From Senator Akaka's office, we'll note this:

WASHINGTON, D.C. -- Following a hearing today on how the Department of Veterans Affairs (VA) processes claims from veterans seeking benefits, U.S. Senator Daniel K. Akaka (D-Hawaii), Chairman of the Veterans' Affairs Committee, urged interested parties to continue offering suggestions on how to improve the timeliness and accuracy of VA's claims adjudication.

"Compensating disabled veterans is among VA's most solemn obligations, and fixing the current system demands our best ideas. I am pleased that the Claims Processing Improvement Act is moving the discussion - from whether to change the status quo - to how to change it. I intend to move a claims processing improvement bill forward, and I ask those with an interest in this issue to continue to share their ideas," said Akaka.

Last month, Senator Akaka introduced S. 3517, the Claims Processing Improvement Act of 2010, to improve VA's disability claims processing. The bill would make various changes to the way VA processes disability compensation claims, including provisions to: • Set up a process to fast-track claims that have been fully developed; • Help veterans with multiple disability claims by allowing VA to provide partial disability ratings; and • Require that the Department give equal deference to the medical opinions of a veteran's non-VA doctor.

At today's hearing, top VA officials, veterans organizations and advocates testified about the current status of VA's claims processing system and made suggestions for changes to S. 3517. Today's hearing and the current legislation are a continuation of Senator Akaka's ongoing effort to improve the claims processing system. Akaka sponsored many of the provisions of the Veterans' Benefits Improvement Act of 2008, enacted as Public Law 110-389. This and other bills have improved claims processing and enhanced compensation and other benefits for veterans. During Akaka's chairmanship, Congress has funded the hiring of thousands of Veterans Benefits Administration employees to respond to the rising number and increasing complexity of claims for disability compensation and other benefits. More information about the hearing including statements, testimony and the webcast is available here: veterans.senate.gov-END-

Because there was a lengthy break between the first and second panel, I was able to catch the second panel. The second panel was composed of the American Federation of Government Employees' Linda Jan Avant, the National Organization of Veterans' Advocates Inc.' Richard Paul Cohen, VA's former Under Secretary for Benefits' Joseph Thompson and Disabled American Veterans' Joseph A. Violante. It was Linda Jan Avant's birthday and Chair Akaka wished her a happy birthday and noted her mother was present for the testimony. Thompson felt that the system was out of date and cautioned on the reading of pilot programs. The system being out of date provided a new "challenge" ("challenge" was his most used term). He saw each challenge as an opportunity. Avant went over the work requirements and duties. And, guess what? Under-staffed and the new staff -- permanent staff brought on by the economic stimulus -- will require at least two years to be fully trained. (These days? They busy themselves with photo copying.) Joseph Violante noted the VA's desire to get rid of the backlog, "Mr. Chairman, the backlog is not the problem, nor even the cause of the problem, rather it is just one symptom, albeit a very severe symptom, of a very large problem: too many veterans waiting too long to get decisions on claims for benefits that are too often wrong."

S 3517 was the heart of the hearing and it is a bill proposed by Senator Akaka entitled "Claims Processing Improvement Act of 2010." Summary of the bill, "To amend title 38, United States Code, to improve the processing of claims for disability compensation filed with the Department of Veterans Affairs, and for other purposes."

Chair Daniel Akaka: While my legislation [S 3517] is largely a claims processing bill, I included a pilot program to test an alternative to the current rating schedule. I did this because I'm concerned that progress on claims processing will be limited until the rating schedule is reformed. Do you agree that status quo on the rating schedule is unacceptable? Do you have suggestions for specific changes?

Joseph Violante: Mr. Chairman.

Chair Daniel Akaka: Aloha.

Joseph Violante: Certainly DAV believes IB believe that changes are necessary; however, we have some concerns about the proposal and the legislation. As has been pointed out previously, we believe that there could be a great inequity in veterans similarly situated, the same disability being rated differently. In addition to the act, the VA will have to learn two different systems because not everyone will come under this new pilot program. If these two veterans -- one who is rated under the current system, one who is under the new pilot -- appeal those decisions, then the Board of Veterans Affairs and ultimately the court also have to make a determination based on two different sets of criteria. And we believe there have been other proposals out there again by the Veterans Disability Benefits Commission and the ongoing advisory committee that have made recommendations that should be looked at also and not just focused on this one change.

Chair Daniel Akaka: Mr. Cohen?

Richard Cohen: Thank you, Mr. Chairman, NOVA believes that you're on the right track on this proposal. As you suggested, the status quo is unacceptable. The present schedule is too difficult for rating teams to work with consistently. This is uh a well thought out system. Uh, the problems that were perceived by some -- and Mr. Violante had mentioned about the disparate treatment -- could be resolved by taking files that had already been rated into the pilot to see what the result would be had they been rated under the pilot program and not changing the particular rating that it had but just seeing how it would be rated under the new program. That's a way that the program could be tested on a pilot basis and then compare the results. And actually, the rating team could be requested to provide input on the difficulty or ease of using both systems. But the proposal that you've come up with is something that it time honored. It's been used consistently in the workers' compensation system and doctors know how to deal with frequency of symptoms and severity of symptoms so it should work.

Chair Daniel Akaka: Thank you. Any other comments?

Linda Jan Avant: Yes.

Chair Daniel Akaka: Ms. Avant.

Linda Jan Avant: AFG also agrees that the rating schedule does need to be updated. I understand VBA has been working on that. There are some sections that have not been updated since 1945. And as a rating specialist, viewing actual medical evidence, it's very apparent that there hasn't been a lot of changes in the information requested on the VA template, that what the rater gets and when they try to apply to the schedule, many terminologies and diagnosis have changed over the years. Also many items seem to be under-evaluated, musculoskeletal are very difficult. If you have a knee condition, it is easily -- does not reflect what the symptons are in the VA exam and some of the mental disabilities are also the same way. And we think it would be beneficial if there are changes. The changes to the ICB Code? It will take some adjustment if VA does change from our diagnostic code to the ICB Code but it is something that is used nationally and with all physicians so it is something that would be easily adaptable.

And we'll skip Thompson because the answer wasn't that in depth and we're short on space.

Today Chris Vallance (BBC News) reports that US State Dept spokesperson Megan Mattson has stated that State Dept cables may have been stolen as a result of "greater information sharing" among government departments following 9-11. The BBC argues this is how Bradley Manning could have accessed documents if, indeed, he did. (They state she argues that but they don't quote Mattson actually doing that.) And on this topic, dropping back to yesterday's snapshot, these three paragraphs confused some:

Monday April 5th, WikiLeaks released US military video of a July 12, 2007 assault in Iraq. 12 people were killed in the assault including two Reuters journalists Namie Noor-Eldeen and Saeed Chmagh. Monday June 7th, the US military announced that they had arrested Bradley Manning and he stood accused of being the leaker of the video. Philip Shenon (Daily Beast) reported last month that the US government is attempting to track down WikiLeaks' Julian Assange. Last Tuesday, the military charged Manning. Leila Fadel (Washington Post) reported he had been charged -- "two charges under the Uniform Code of Military Justice. The first encompasses four counts of violating Army regulations by transferring classified information to his personal computer between November and May and adding unauthorized software to a classified computer system. The second comprises eight counts of violating federal laws governing the handling of classified information." Today on Antiwar Radio, Scott Horton discussed the issues with Glenn Greenwald. Strangely, Glenn Greenwald was able to talk about what Bradley was charged with, what he was alleged to have done. Example below.

Glenn Greenwald: Well one of the interesting parts of the charging document is how different it is than the chat logs that were released by Wired magazine in which he allegedly confessed to this hacker Adrian Lamo which is what started this case in the first place. There's a lot of facts that are very different if you look at what the charging documents said he did versus what he allegedly said in those chats.

In the final moments, Scott would point out that Wired refused and refuses to release the alleged transcripts in full (unexpurgated) and Glenn would talk about how, based on his legal experience, when someone refuses to do that, they generally are attempting to conceal something that doesn't jibe so easily with the rest of the narrative. This was a very brief segment.

There were five paragraphs. The confusion isn't the fault of anyone trying to follow along. The snapshot was too long and that's one of the dangers of editing in your head without looking over it. I said, "Pull __ and pull ___" and two of the paragraphs pulled (there was more pulled but that was largely a commentary about the State Dept event with Hoshyar Zebari and Hillary Clinton) were after "a very brief segment." I wrongly thought the comparison had been made in the above paragraphs. If you drop back to Friday's snapshot, you'll note it opens with Nancy Youssef's garbage -- broadcast over NPR's The Diane Rehm Show -- about Bradley. In Nancy's world, if you're charged with something, you are guilty. In Nancy's world, if a convicted felon insists you said something, even though you've never publicly stated anything, you said it. The term "allegations" is as foreign to Nancy as is "innocent until proven guilty." To show your support for Bradley -- who's been found guilty of nothing at this point -- you can click here:

Sahar Issa (McClatchy Newspapers) reports a Baghdad sticky bombing wounded two people and, dropping back to Tuesday, a Mosul bombing in which eight children and one police officer were wounded, 2 Baghdad roadside bombings which claimed the lives of 2 police officers (and wounded five more people), and a Baghdad sticky bombing which injured two people. Reuters notes a Mosul roadside bombing which injured one Iraqi soldier, a a Baghdad sticky bombing which assassinated 1 "senior appeal court judge," 2 Baghdad grenade attacks in which four police officers and three civilians were injured, a Baghdad sticky bombing which injured a Sahwa member, a Mosul bombing which left two people injured, a Kirkuk roadside bombing which injured four police officers, and an Abu Ghraib home bombing (home was base for Abu Ghraib military) in which 2 Iraqi soldiers were killed.

Shootings?

Sahar Issa (McClatchy Newspapers) reports a Yousifiyah home invasion ("around dawn") on the home of Sahwa leader Khudhair Ouda in which his wife and 3 sons, a Falluja home invasion on "the home of a candidate of the National Unity Coalition" in which "his wife, daughter and son" were killed (the politician was not at home) and, dropping back to Tuesday a Baghdad home invasion in which university professor Adnan Mekki Abdullah was shot dead. Reuters notes an armed attack on a Baghdad checkpoint which resulted in three people being injured, 1 man shot dead in Mosul, a Mosul military raid which claimed the lives of 3 'militants.'